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Discharged: No Help For Homeless Alcoholic

Last Wednesday night, my friend Deb and I went to the ER at Wesley Long with a Community Dinner guest. He was having DTs really bad and he wanted help. He told us that he wouldn’t make it through another winter on the street. We hoped to get him into a detox and then into a residential rehab. He was ready and willing. But he kept telling us that it wouldn’t work — that every time he’d tried to get sober, they’d detox him for a couple of days and then put him back out on the street without sending him to a rehab program. He said, “To them, I’m just a poor, homeless drunk.” We assured him that wouldn’t happen this time. (But apparently, we were wrong.)

Late Wednesday night, we were told that the State was out of money to do detox, so they couldn’t send him to a detox facility. They did agree to admit him to Wesley Long, and our congregational nurse case manager from Grace followed up the next morning. A Wesley Long social worker looked into rehab options and so did Grace’s nurse case manager. I had planned to call our nurse this afternoon to find out where our friend was going to rehab this week. But before I could do that, I got a frantic phone call from him as I was on my way to church this morning. The social worker hadn’t found a rehab spot for him yet. So he was being discharged. With no place to go.

Today is Sunday. The offices of rehab facilities, transitional housing programs and homeless shelters are closed. Case managers, outreach workers and volunteers have the day off. And on a Sunday morning, many of us are at church. And yet, that’s the time when Wesley Long Hospital decided to discharge a homeless alcoholic (with other medical problems) — just four days clean — with no discharge plan and no place to go.

We recently presented the Ten Year Plan to End Homelessness in Guilford County. We talked about the need for substance abuse treatment. We talked about the importance of discharge planning and zero tolerance for discharging homeless people to the street. I served on a committee with a Moses Cone vice president. (Wesley Long is owned by Moses Cone.) We know that we need more substance abuse treatment options. But we don’t have them. We know that we’re not supposed to discharge homeless people to the street. But we keep doing it anyway.

Before he left the hospital, I called and questioned why our friend was being discharged without a plan — to the street. One nurse was sympathetic but unable to help. Another was hostile and defensive. I got nowhere. I called our friend back, feeling frustrated and hopeless that he was running out of time and I couldn’t do anything. And he comforted me. “It’s a losing battle at this point,” he said, in a voice that sounded so used to losing that it made me want to weep and scream and rage and fight against all the injustices done to this man from his tragic childhood until now, and against all the injustices done to our homeless friends who walk wounded and scarred in a world that ignores them or blames them or just doesn’t care.

When I got out of church a couple of hours later, our friend was standing in the exact same spot in the parking lot where an ambulance had picked him up four days earlier. Wesley Long had graciously provided him with a taxi voucher after unceremoniously discharging him, and he’d returned to us because he had nowhere else to go.

Once again, he’d asked for help. Once again, he’d had a few days of detox and then been kicked out, back to the street, with no rehab, no real help. But he didn’t seem surprised or upset. Because he never really thought it would go any other way. After all, to them, he was just a “poor, homeless drunk.”

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God, I know that you make a way where’s there no way. I’ve seen You do it before, so many times. I’m sick and tired of trusting man’s broken systems. Heal Your people. Comfort the wounded. Save the lost. Show me how to be Your hands and feet. Forgive me when I fail. “My hope is built on nothing less than Jesus’ blood and righteousness…”

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From the Guilford County Ten Year Plan to End Homelessness:

Objective:Provide prevention and supportive services to prevent persons from becoming chronically homeless and to enable those who are chronically homeless to move to and remain in a stable housing situation and maximize their self-sufficiency.

Identified need:Need for stronger prevention at discharge

Strategy:Ensure that every person being discharged from jail, hospitals, mental health care, or foster care has a discharge plan that leads to stable housing and supports a community policy of â€œzero toleranceâ€ for discharge to homelessness.

Action Step:Appoint a team of key agencies to serve as a Discharge Planning Task Force.

Benchmark:Discharge Planning Task Force is appointed by first quarter 2008.

So how’s that plan coming, y’all? I haven’t heard another word. I guess I’ll believe it when I see it. And when Wesley Long and Cone stop discharging homeless people to the parking lot of my church. Because this is not the first time that’s happened. And I’m afraid it won’t be the last.

6 thoughts on “Discharged: No Help For Homeless Alcoholic”

I just want to say whatever it is worth that I think the strategy is realistic and appropriate and I am very thankful for thew work you do and the passion you have. You know we have a way of defining people according to how well they are able to “make it” in the way we have built and structured society, and the real and deep humanity and even good and giftedness of people who for different reasons can’t “make it” just gets lost, and they get lost and forgotten except for a few people like you who know them, and their stories, and who know better. I don’t know this man, and have no basis for making any comments except what you have written, but I am guessing he isn’t going to make it, and wouldn’t even if he had treatment. Some people just can’t stay sober, detoxed, work a job, succeed in this life as we have more or less defined that. So, what do we do. It seems we need to have facilities for their care. But what if they won’t stay? Do you think it is just for people to be made to stay in facilities designed for their care? In our idealism and high mindedness and reacting to horror stories of “state hospitals” we have fed a generation of people to the wolves and ravages of life on the street in the most deplorable of conditions. Would could your plan and proposal include institutionalization for those for whom detox, treatment, and half way houses just don’t work?

Joel, I think he can make it. The more I learn about the science of addiction, the more I realize that we need to design better strategies to help homeless and poor people get the tools they need for successful recovery.

I believe that if you’re still breathing, then you have a chance for successful recovery. I’ve seen a friend who was a homeless alcoholic for decades get clean and sober and stay that way. No one thought he would live another year. Today he’s doing well. He’s not the only one. He finally got the interventions he needed to support his recovery. It took years of trying.

Recovery is a process. What I have seen in the years I’ve been doing homeless ministry is that people who have been homeless and addicted for years usually need supportive, structured, long-term programs to help them through the process of recovery, although that can look different for different people. And they need stable housing and an ongoing support system. But they can and do get better.

As for involuntary housing, mental health “reform” (haha) has moved us away from institutionalization. But I suspect that there are some who would benefit from living in an assisted, group living situation, provided that it was a loving and nurturing environment. As for making that involuntary, I’m not sure where I stand on that. There are a lot of people that I’d like to “make” get help. But if I could, would I? I don’t know. That’s a complicated question for me. I’ll have to give it more thought.

The Ten Year Plan favors long-term supportive housing for chronically homeless people with addiction and/or mental illness. Guilford County recently received two grants to provide supportive housing for homeless mentally ill people. That housing will be in private units. This type of housing seems to be working well in other communities. I hope we’ll see similarly good outcomes here.

Cara, I see this kind of scenario play out nearly every day with the various psychiatric scenarios (including addiction).

Night-shifters and weekenders are the bastard stepchildren of medicine (my colleagues and I were talking about getting T-shirts just the other night). I’ve chosen to work them both . . . in large part because some of the best of medicine can be found there.

As for the problems you encountered (i.e. a forced discharge to nothing on a weekend), in a choice between reimbursement and compassion . . . if you expect a hospital to act with compassion and common sense . . . you are going to be disappointed every time.

Dear this story brought back the memories and with them the tears. Dear Lord how we can call ourselves human and spend money on golf courses and money-pit coliseums and billion dollar companies is beyond me when so very little could do so very much for people who really need our care.

Believe me when I tell you that things are really better now than they used to be tho. I remember having no place but my own home to take people. As you know this isnâ€™t the best thing to do because they will become dependent on you and the budget just didnâ€™t stretch that far. So we did what we could and gave them food and old blankets and clothing that people donated and hoped they would find some bridge to crawl under out of the rain and snow. Hospitals wouldnâ€™t take addicts at all unless they were on deaths door, and the few shelters wouldnâ€™t take them either. But the worse thing was that no one would talk about the problem and no one would admit that there was a problem. You canâ€™t get anything done until you admit that something has to be done. So things are better.

And, sadly I have to agree with Joel that some will never be helped. Sadly some donâ€™t really want to get over their addictions either. When facilities are limited you have to try to help the ones who might have a chance and let some go no matter how bad it hurts.

And I was one of those damned flaming liberals who demanded the institutions be closed down because these people werenâ€™t criminals to be locked up! So the states gladly closed down the institutions and put these â€œnot criminalsâ€ out on the streets with the real criminals to be raped, beaten, robbed and killed. We were so stupid!!! Not all institutions were bad.

Oh well. My prayers are with you Honey. Brenda

Mr. Robinson the community can not move on and commence healing until the current problems are resolved. There is too much corruption and lies in seats of power and city departments that must be weeded out, and until they are Greensboro residents will continue to tear at each other. I have only lived here since October 2004 but I have studied city history thru the N&R and The Rhino archives as well as city and county records of meetings thru the last 4 decades and I have not yet found a time of “peace” in Greensboro. The races are further apart now than ever in my opinion. The distrust of city government seems to be a way of life. And too many problems have been just shoved under the rug without a satisfactory outcome with the ambiguous words â€œLet healing begin.â€(Project Homestead is the one that comes to mind first. Those who are guilty are still out there and many are still in power.) The city fathers are completely out of touch with the residents and the real needs in the community. They are putting hundreds of thousands into parks used by relatively few and letting the police department staff fall to skeleton crew levels. Giving hundreds of thousands to well off companies while sewage spews thru our streets every time it rains.

Healing can only come after the infection has been cleaned out and sanitized. Sorry, this is not what you wanted to hear, but these are the sad facts. Brenda Bowers

The Chosen Fast

"This is the kind of fasting I want: Free those who are wrongly imprisoned; lighten the burden of those who work for you. Let the oppressed go free, and remove the chains that bind people. Share your food with the hungry, and give shelter to the homeless. Give clothes to those who need them, and do not hide from relatives who need your help." ~ Isaiah 58:5-7